Infinity Beauty Cupping Consent Form & Liability Waiver
Updated: 5/2020
Cupping at Infinity Beauty is an adaptation of an ancient technique; the purpose of this technique is to promote health and healing by loosening soft tissue and connective tissue, scarring, and adhesions moving stagnation and increasing lymphatic flow and circulation. This therapy utilizes silicone or plastic cups and a vacuum pistol to create suction on the body surface. These cups are moved over the skin using gliding, shaking, popping, and rotating techniques while gently pulling up on the cup, or maybe parked for a short time to facilitate joint mobilization or soft tissue release. Suction reaches deep into the soft tissue, attachments, and organs. Another benefit is to pull toxins and inflammation from the body to the surface of the skin where the lymphatic system can more readily eliminate them.
Potential reactions to Cupping Therapy are temporary and may include:
o "Cup Kiss": discoloration (has bruise-like appearance) due to toxins and old blood being brought to the surface
o Post tenderness: usually less than experienced from deep tissue work
o Redness and Itching: increased vaso-dilation and/or inflammation brought to
the surface
o Decreased Blood Pressure: due to vaso-dilation and/or nervous system sedation
Suggested aftercare recommendations:
Drink plenty of water, to help eliminate toxins out of the body.
Avoid showers, steam, sauna, and exercise immediately following Cupping Therapy.
Light stretching and range of motion exercises are beneficial.
Exercise the next day will help increase circulation to aid in the fading of cup kisses.
Contraindications:
People who are on blood thinners should not receive Cupping. If you start taking such medication please inform the beauty consultant prior to the start of service. If you are under the care of an acupuncturist, Cupping could
potentially interfere with acupuncture treatments and should be avoided.
By choosing to experience this Cupping Therapy, I understand the effects and after-care recommendations. It has been explained to me that there is the possibility of a temporary skin discoloration or “cup kiss”, appearing as tissue is released. I am aware that a “cup kiss” has a bruise-like appearance and I understand that it usually dissipates within a few hours to a few days depending on the individual.
I understand that all treatments by the Beauty Consultants at this boutique are for relaxation. They are not intended to treat any pre-existing health conditions. I agree to notify the beauty consultant if I experience any physical discomfort experienced during the session. I have stated all relevant physical conditions and will consult with my physician prior to receiving this treatment as needed since Infinity Beauty is not a health care provider.
All Infinity Beauty Consultants and Technicians are thoroughly trained in each area of service. Infinity Beauty is not a health care provider. We do not prescribe medications nor do we diagnose any conditions. Please consult with your health care provider prior to scheduling any services at Infinity Beauty. By Scheduling an appointment at Infinity beauty, you are acknowledging that you agree to the service(s) and release Infinity beauty of any liability as it pertains to the services offered. You also attest that you are in good health and that the contraindications do not apply to you.
Media Consent I Give Infinity Beauty Permission To Use My Photos And Videos.
Consent* I Consent And Agree To Receive Services At Infinity Beauty.
I consent to receiving services at Infinity Beauty. This waiver and consent form is valid for this visit and any future visits at Infinity Beauty.